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Chair:    Davera Gabriel 

Scribe:  Davera Gabriel 


Tuesday, Dec 13th, 8:30-10:00PM UTC

Tuesday, Dec 13th,  3:30-5:00 PM USA ET

Wednesday, December 14, 7:30-9:00AM (next day) AEST

Wednesday, December 14, 9:30-11:00AM NZDT   


Attendee type:

M - TSMG Member

O -Observer / Guest


P - present

A - Apologies

X - (Apologies with Proxy)



M (Co-Chair)X - Proxy to DaveraClinical Architecture
M (Co-Chair)
The Johns Hopkins University
M (Co-Chair)X - Proxy to CarolSaludax
HL7 International
M (TSMG Rep to the TSC)P - arrived at 25 past the hourMD Partners, Inc.

X - Proxy to Reuben, arrived at the 1 hour point

MPApelon, Inc.
National Institute of Standards and Technology (NIST)
MX - Proxy to ReubenHL7 New Zealand
Precipius b.v.
HL7 Germany
Health Intersections
Canada Health Infoway
OPNational Library of Medicine
Hausam Consulting LLC
SNOMED International
OP arrived at the 1 hour pointMITRE
Joe FlackJohns Hopkins BIDS
Office of the National Coordinator for Health Information Technology (ONC)
John SnyderNational Library of Medicine (US)
Ted KleinTK Consulting
Lloyd MackenzieAccenture
Ravi KafleWashington State Department of Health
Doug DeShazoLexisNexis
MaryKay McDanielFM/Markam
Corey SpearsMITRE
John SpinosaLantana
Harold SolbrigMayo
Joe AmlungReginstrief
Martha JonesHL7 Intern
Riki MerrickVernetzt, LLC
Gaurav Vaidya
Emily PfaffUNC
Eric PrudhommeauxJaneiro Digital
David BoothYosemite Project
Jim BalhoffUNC
Christian ReichOHDSI
John Carter
Marc DuteauHL7
OPJuliet RubiniICF

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Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Agenda Topics 

Meeting was recorded. Note items in RED below are deferred due to lack of time

Agenda Outline

Time allocationLead

Agenda Item


  • Announcements
  • Upcoming Meeting Schedule (Quorum is 6 attendees + 1 co-chair)
    • 12/13 - Carol and Reuben out
    • 12/20 - Canceled 
    • 12/27 - Canceled
    • 1/3 - Davera and Reuben out
    • 1/10 - Meet, final prep prior to WGM
      • Agenda placeholder for IRI follow-up:  Gaurav
    • 1/17 - WGM
PSS Needing External Review
TSMG Standing Subcommittee Updates

 HL7 Terminology / Unified Terminology Governance (THO/UTG)As neededJB/RM/CC
  • Terminology expectations for IG developers
    • CM sent the Clean draft for TSC consideration located here: Terminology Expectations for IG Developers (Draft For Consideration) on 12/12
    • RM will help track request for time on the TSC agenda to provide a walk-though of this policy
    • Lloyd M has suggestions / changes re: "temporary" codes and where these should be managed
      • suggests that THO is not the right place for this unless there is certainty that this will reside in THO in the future
      • RM:  asks LM for suggested verbiage to change
      • (12Dec22) Lloyd McKensie has contacted TSMG via eMail and would like to provide alternative wording to address a workflow for temporary codes.  
      • Carmela Couderic has indicated she is not in favor of using any text string (e.g.: "temporary") in the identifier that confers meaning 
      • RM: suggesting that there should be some governance around how long a temporary code system can be used. 
        • This is intended to be a solution when the IG needs to use concepts that are intended to be added to an external code system but are not yet available. In this case it is acceptable to make a TEMPORARY code system to hold the codes until they show up in the external code system.  
        • This TEMPORARY code system should not be used "forever" and use could be limited to value sets with  less that FMM3. Potentially restrict a time duration.
        • If the codes are not added to the external code system then the TEMP code system may end up with a new  name and url change and made an internal code system
    • CM:  request made via eMail for this to go on the TSC agenda such that it can be discussed / finalized in the WGM
  HL7 Terminology / Unified Terminology Governance (THO/UTG)10RD/JB
  • Disposition of the CDCREC on THO
    • Lenel James is requesting this as "CMS has issued proposed rules for 2024, that assume the standards are already in place and ready for usage."  As such there is some urgency placed on resolution
    • JB: needs to understand where the content is
    • JB: also needs to have an official "go ahead" to place the CDCREC on THO (even if its location was know).  Presumably this permission would come from HQ
    • PM: FYI: there is a copy of the CDCREC on the VASC (versions 1.1 & 1.2) that came from PHIN VDAS originally
  • Technical correction for THO due to issues with OIDs (see notes from Vocab call here 2022-12-01 Vocab WG Call Agenda/Minutes)
    • There is no additional information about the dates of the technical correction at this time, and this is needed
  • Duplicate URLs in THO
    • Duplicate URLs in THO for CVX: vs.
    • We retired the entry from V2, but according to Grahame this will still cause issues with the IG infrastructure getting things wrong
    • He suggests we remove from THO
    • RM: states this is clearly an error and these two pages should only be one page.  The content in the retired page should be represented in the active page, and the retired page removed.
    • This reminds us that by using the special url config in the publisher the url that is indicated as special is not checked against other things in the ID and therefore in the checking in the IGs were not checking the appropriate information.
    • Suggestion to confer with HTA to see what information from the retired page needs to be ported to the active page.
  • Recommendation from Vocab to TSMG on handling of THO OIDs
    • Review minutes from Vocab: 2022-11-17 Vocab WG Call Agenda/Minutes
      • open questions about how to handle oids that are duplicates between FHIR Core THO.  JB has started this discussion
      • Vocab needs to wrap up remaining issues: if oids are duplicate and published... if these should be published using identity period.  Grahame isn't doing this for FHIR core.  The differing solutions should be aligned - this discussion should ensue in the Vocab WG
      • Also of issue - is there the decision about who will be correcting this. 
  • Review fix for 'All HL7 Code Systems' tab
    • UP-320 - Getting issue details... STATUS
    • Options are to break down by product family or maintain two separate manifests (more work and more prone to error), more details in ticket comment
    • Discussion included adding the following comment to the ticket: 
      • Discussion in TSMG meeting 13Dec22 included a suggestion to define a THO category extension that could be used to drive categorization of these pages within THO, reducing the need to manually maintain manifest lists for each product family, etc.  This could be enabled through a custom xslt template.  This would be a good solution conferring a reduction of work for THO maintenance. 
    • Decision on this topic requires a vote.  Quorum not established but discussion was fruitful

Parking lot and work in progress

  • Workflow for THO releases (moving content approved in ballot to THO AND how to handle missed THO deadline)
    • Requires discussion - priority item to resolve
    • This is a key component of the IG Developer tutorial
    • This item is blocked without the expectations for IG developers policy being developed.
    • 8Nov22 TSMG meeting: deferred
  • Versioning policy for UTG/THO
    • Finished proposal for HL7 Code System elements
    • There are a few higher level considerations before moving over to Value Sets
    • Progressing to finish HL7 Value Sets and moving to External Identifier System Metadata Records
  • Many CodeSystems use urls when they should be FHIR-37440 - Getting issue details... STATUS
    • UTG/THO subcommittee working through differences across elements for duplicates to determine what is consequential 
    • Need a follow-up with Grahame Grieve. Will invite him to this week's THO/UTG Subcommittee call.

HL7 Terminology Authority (HTA)

    • Next meeting on Wed 14 December 3-4pm EASTERN US.  Not sure who among the co-chairs are available to chair the meeting.  Davera will follow-up and provide a cancellation if not co-chairs are available
Outreach & Education

  • Vulcan FHIR to OMOP project
    • Track in the January Connectathon
      • validation architecture based on CAMP FHIR
    • Vulcan 101 presentation section (14Dec22)
    • Environmental scan report - started
  • Alignment of Value Sets across product families - with Lisa Nelson
  • Develop standard curriculum requirements for 3 workshops:
    • Intro to FHIR Terminology
    • Advanced FHIR terminology
    • Terminology for IG Developers
  • Write-ups for dissemination (to be developed)
    • Accessing CDCREC Value Set
    • Using ICD-11 on FHIR
    • Terminology Expectations for IG Developers (component of workshop above)
Technical Steering Committee (TSC) matters10RM

TSC Membership - (deferred: RM not available today)

    • RM considering remaining in place as TSC representative.  This would require adding Rob as a TSMG member becuase all the presumed empty slots have been filled.  
Parking Lot 

  • Terminology Server (Implementation Requirement)
    • Follow-up from WGM - next steps re: terminology server (service) requirements (1-page description)
  • UTG / THO Subcommittee work in progress
    • Vocab WG follow-up: Policy Requiring Identification of Stewards for HL7 (Internal) Code Systems

Supporting Documents

Outline Reference

Supporting Document